Mr D Jones & Teddy

Keymaster

I just came across this forum while doing a search for rather loose stool while weaning my 8 yr old Cocker spaniel off the horrible [and expensive] meds, Cyclosporine and Pred. This whole AIHA thing bothers, confuses me and seems to be ‘ a diagnosis’ that is becoming far too popular and convenient for some vets. My four legged son Teddy was diagnosed with ‘auto-immune disease’ in March and like many of you experienced was given a dispensary full of meds which eventually were reduced to the continuance of Pred. and Atopica, which has now been 4 months. Personally I think Teddy has been diagnosed with something he DOESN”T have, and didn’t have and has been converted into a pill junky that i believe are doing more harm than good. His story began in Late Feb with a trip to the vet for skin allergies and was prescribed antibiotics [he has been on so many meds lately I cannot remember which it was but I believe it was Metro or Flag] 7 days later there was traces of blood in his stool so vet says to stop antibiotics, he needs a blood test. $300 later he had bloodwork and I got a call later in the day saying he had ‘Auto-Immune Disease’, and he needed Prednisone immediately with chances of survival being 50/50 after possibly a year or more of recovery. I rushed down for the Pred and the next day Teddy began vomitting massive pile of blood. After extreme panic I was told to rush him to the hospital, likely within hours of him passing. Being our countries premier pet cancer facility they pushed the ‘cancer’ scare on us and said it could very well be what it was. We were shown very little compassion and were quickly asked to give an $1,800 deposit. For the 1st 12 hours the bill was $1,950 and I was told for 3 days on IV and tests the bill would be about $5,000, plus if he had to see the cancer team, blood transfusions, bone marrow work etc it would be more. What happened to the auto-immune disease? In complete shock I began doing research and after about a half hour discovered that the NUMBER ONE cause for his symptoms was the anti-biotic he was given the previous week! When I confronted the doctor I was told that could absolutely be the case and I never heard the word cancer again, BUT he was put on an auto-immune disease regiment. I was told again by these so called ‘experts’ [?] that it was going to be a long recovery, if he pulls through as his blood was basically eliminated. 5 days after he came home he had his first check-up and his blood #’s were about 75% normal and at normal in about 1 month. Is this really auto -immune? The red and atomic have ruined his personality and life style as his body aches, he has gained many lbs, and is tired all the time. $7,500 later I am weaning him off on my own accord as I am not going to play the game any longer. I would rather not see him limp in discomfort for what has now become merely a few minute walk. When I suggested they are possibly treating him for something he may not have I got no denial or resistance, and also know I was lied to regarding other med related matters. His blood has been at normal counts for the past 3 months yet every 3 weeks he has blood tests and his dr wants to sell us more meds at $200.00 / mo for the next 6 months “Just to be safe”. Safe? What about the side effects, so aching joints and no immune system and now dealing with infections is deemed as the safe route? I wish there was a crystal ball that showed us what is killing our beloved pets, be it food related or environmental – or both? I hope I am not wrong with my own evaluation and the word ‘relapse’ frightens me. Can our high priced vets really be trusted and are they in our best interest or in it for theirs? Good luck and a big heart goes out to all of you that have four legged kids going through this. Regards, D Jones

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Patrice

Keymaster

Hello Mr. Jones,
I am sorry to read the complete story about your Cocker Spaniel. You and your family have been through a lot of agony and stress. I am terribly sorry that you have had to try to find our help.

But I can guarantee that we are the best place for you to talk about this. We have years of experience and knowledge. Our goal is education and helping owners understand the complex medical knowledge that many of these owners HAVE to know to actually get their dog treated properly. An owner that has a good knowledge of what their vet is telling them will be able to make calm and educated decisions, not in a panic, but with thoughtfulness, not only in terms of the expected success or failure, but also with their dogs’ comfort in mind and trying to complete the treatment in an economical way. Many families do not have a lot of money to throw at these conditions.

I wish I could reaffirm your concerns that you were singled out,misinformed and additionally that these conditions are rare. The reality is that the number of dogs with these various hematological conditions we have seen on our forum and I have seen in the past 8 years has significantly increased.

Why is this occurring? We need to look carefully at how autoimmune diseases present in canines and also at how susceptible dogs as a species are to these various autoimmune diseases. In addition to what I have written please take the time to carefully and thoughtfully read this excellent paper written by Dr. Jean Dodds
The Canine Immune System and Disease Resistance
http://www.canine-epilepsy-guardian-angels.com/ImmuneSystem.htm

These conditions are extremely variable in how they present. My dog Chance, in whose name this site is in memory of, presented with a very gradual and persistent non-regenerative anemia. The story is far more complex than that, and you can read many of Our Stories by finding this in the menus at the top of the page.

Chance’s condition, in 2007, was puzzling not only to my vet, but surprisingly puzzling to the specialist I saw as well. So the signs were a gradual decrease in red blood cells and white blood cells over time. Nothing dramatic but a diminishing of his ability to make these kinds of cells. But it was an insidious and deadly condition, combining complex autoimmune issues with complications from autoimmune hypothyroidism and digestive disorder with the possibility that he had a vaccine reaction to the parvo booster. Chance did survive this condition, despite the discouragement by the specialist. You see his after picture on this website.

Chance was prone to autoimmune disease from before the day he was born. He developed serious canine allergies (atophy) when he was only 1.5 years old. Now-a-days I would immediately recognize that this sets up a dog for future autoimmune conditions. But at that time, the study of canine allergies was literally just a specialty and in it’s infancy. We were certainly lucky that we had one of only 25 veterinary dermatology specialists in the whole US in our area. Chance was treated with a complicated and highly expensive dosing of allergy shots, a novel and successful approach in 2007. This worked for him.

Little did I know that many years later, his autoimmune tendencies would catch up with him, the next time as diagnosed autoimmune hypothyroidism. A new puppy sidetracked us and it wasn’t until he began to experience severe digestive disorder did we begin to understand that something more was seriously wrong. My vet discovered and removed a 7 lb growth from his spleen. Abnormal? Well, now that I have had years to research this, no, this is not unusual for dogs to develop this accessory spleen. In fact, this growth was making blood for him because his bone marrow had failed. I didn’t finally put all this science together completely until after years of studying veterinary hematology, and long after Chance had passed.

So now we look at how dogs with AIHA and IMHA express and show signs of these conditions. Extremely variable. And the trigger? Many. In fact, most dogs do not develop disease from one singular trigger. It is a “perfect storm” of several triggers.

The most serious cases of AIHA (usually considered a primary condition of unknown cause) demonstrate as a sudden and profound autoimmune destruction of not only red blood cells but sometimes platelets as well. They can literally go from a PCV / HCT of normal (38-55%) to one of something like 8% in a matter of days, even hours. These dogs are highly prone to crashing, developing a serious blood vessel disorder called DIC disseminated intravascular coagulation in very short time. A vet not experienced with handling this condition can fail to not only recognize the signs but also fail to know how to treat this emergency. These dogs do not do well and unless they are in the hands of an experienced and talented veterinary team, they will not survive. And make no mistake that I truly believe that this treatment is like an art. These vets develop extraordinary and unique protocols to treat these dogs. Many other vets are still in their office doing a quick internet search about the condition while these folks are quick in action.

We often see cases of IMHA (immune mediated hemolytic anemia) (which is the more currently correct term that indicates that there is “some trigger” that may be treatable) that is leading to this sudden autoimmune destruction of red blood cells. A big trigger, one of many, is tick borne diseases. But there are many others, including vaccine reactions, exposure to pesticides (whether applied to the dog or applied to their environment), a history of canine allergies, bee stings, bites from snakes or spiders, genetic history, sex hormones (male or female), age, breed and concurrent health issues such as hypothyroidism, digestive disorders, kidney disease, tumors, splenic disease etc. You can watch an introductory video about this under the AIHA Video Library. These cases may require multiple tests to nail down the cause(s) and there is truly a laundry list of things that should be ruled out. All of us here know these “rule outs” and we are quick to check to make sure these tests were done immediately by the attending vet as soon as a new owner comes to us.

Now we must look at how susceptible dogs are to these autoimmune conditions. Extensive research is now being done on many canine disease conditions, in part, because the canine genome has been completely mapped and that makes this a rather easy task for a researcher. What they are finding is that genetic “baggage” has hitched a ride (like the iceberg UNDER the water) along with genetic information dealing with things like coat color and other characteristics about how dogs “look.” These visual characteristics have driven dog breeding for a very long time.

A dog that has the appropriate breed standard wins dog shows and these are the dogs that breed future puppies. Even if we eventually are looking at a backyard breeders’ dog, we have this genetic heritage in the past to look at. And dogs that are “mutts” are really just a combination of the genetic heritage of all these pure bred dogs that have the original baggage. Just as humans have very little control over whether or not their children will need glasses.

Now we are beginning to realize the horror of these earlier decisions made by unknowing breeders. For instance Dalmatians are being born deaf in extraordinary numbers because deafness is genetically linked with coat color, in this case the gradual shrinking of black from the coat in preference to a white coat with small dots. Make no mistake this was the result of a Disney movie and the popularity of this breed at that time. The science is that the coloring, melanin, that makes black dots is also an important cellular component of the structure of the inner ear. These dogs are born without the proper parts of the ear. The less melanin in the coat, the greater the risk of this genetic fault being expressed.

German Shepherd Dogs have had an increasing tendency to develop hip dysplasia due to the preference for that crouched back leg look. Certain breeds like Cocker Spaniels and Poodles are significantly more prone to developing AIHA IMHA and bone marrow failure owing to the popularity of these breeds and the large demand for puppies. Back yard breeders set themselves up to make some money and pollute the genetic pool without forethought by breeding dogs that may have genetic baggage.

My breed Giant Schnauzers had its genetic future polluted by a few high producing kennels who bred aggressively for show dogs and ignored and refused to apply appropriate genetic information to their kennel breeding stock.

Chance was one of the most expensive “full bred dogs” that could come out of a kennel like that. How would I have known? Certainly not in 1998.

So now we look at your experience. Why did this cost you so much and why do you feel not only so out of control of the situation but also probably feel tremendous guilt? Would it help you to know that all of us have felt this way? We have all experienced this horrible roller coaster ride of panic, ignorance, guilt and grief.

Those are excellent reasons why we dedicate our own personal time to help owners. We don’t stand to gain a thing from this. But we can all tell you that the satisfaction we feel when, after weeks of struggling to help an owner care for their sick dog, the dog survives and begins to play with their toys again in just beyond words.

And when a dog does not survive it is a dreadful experience for us, bringing back memories of our own pain and grief.

Please stay here with us so we can share and have a good conversation about your experience. What you have learned is invaluable to others. We want you to feel at peace eventually, just as each of us has found in time.
my best
patrice

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